Adolescent Treatment Models: Gender Issues

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Adolescent Treatment ModelsGender Issues

• Sally Stevens, Ph.D.
• Research Professor
• University of Arizona
• Southwest Institute for Research on Women
• 3912 S. 6th Ave.
• Tucson, AZ 85714
• [phone] extension 11
• Workshop presentation for SAMHSA-CSAT Adolescent
  Grantee Meeting Washington, DC.
  
• February 23-25, 2004

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Gender Differences in Substance Use, Mental
Health, and Criminal Justice Involvement of
Adolescents at Treatment Entry and Follow Up
Persistent Effects of Treatment Initiative
(PETS)
Although the world if full of suffering, it is
also full of the overcoming of it
-Helen Keller
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Overview of PETS

• Funded through the Center for Substance Abuse
  Treatment
  
• Merged 7 projects within two large CSAT
  initiatives
  
• Cannabis Youth Treatment (CYT)
• Adolescent Treatment Models (ATM)

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Description of Sample

• Sample of 1,207 adolescents who were enrolled in
  substance abuse treatment
  
• Seventy-nine percent (79) were boys and 22 were
  girls
  
• Mean age at baseline for the boys was 15.83 and
  for the girls was 15.66 years old

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Gender Differences in Substance Frequency
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Gender Differences in Substance Problems
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Gender Differences in General Mental Health
Distress
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Gender Differences in Behavioral Complexity Index
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Gender Differences in Days on Probation and Parole
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Conclusions

• Girls enter treatment with more severe score
  (worse) in substance use (frequency problems)
  general mental health distress and behavioral
  complexity compared to boys
• While the change trajectory was similar for girls
  and boys, after controlling for treatment type
  and initial status, the rate of change is
  actually slower for girls.

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Clinical Implications and Treatment Needs (for
girls)

• Earlier identification (schools primary health
  care provider neighborhood centers religious
  institutions LGBT and other special groups
  outreach to youth hangouts and streets)
• Motivational enhancement sessions that can be
  facilitated in non-traditional settings

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Clinical Implications and Treatment Needs (for
girls) (cont)

• Peer based interventions
• Female-specific treatment based on empowerment
  theories (emphasis on safety, trauma, stress,
  relaxation techniques, sleep problems, mental
  health issues, and behavioral problems)

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Instrumentation Issues Categorizing Drugs

• Do you know your drug slang?

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From the Global Appraisal of Individual Needs
(GAIN-I)

• 1. Any kind of alcohol (such as beer, wine,
  whisky, gin, scotch or mixed drinks)
  
• 2 Marijuana, hashish, blunts or other forms
  THC?.
  
• 3. Crack or free base cocaine
• 4. Other forms of cocaine
• 5. Inhalants (such as correction fluids,
  gasoline, glue, lighters, spray paints or paint
  thinner)
  
• 6. Heroin
• 7. Pain killers, opiates, or other analgesics
  (such as codeine, Darvocet, Darvon, Demerol,
  Dilaudid, "Karachi," Percocet, Propoxyphene,
  street methadone, morphine, opium, Talwin,
  Ketamine or Tylenol with codeine).
• 8. PCP (Phencyclidine)
• 9. "Acid" or other hallucinogens ( such as LSD,
  mushrooms, mescaline, peyote, Ecstasy/MDMA or
  psilocybin)
  
• 10.  Anti-anxiety drugs or tranquilizers (such as
  Ativan, Deprol, Equanil, Diazepam, Klonopin,
  Meprobamate, Librium, Miltown, Serax, Valium or
  Xanax)
• 11. "Speed," "uppers," amphetamines, or other
  stimulants (such as methamphetamine, Biphetamine,
  Benzedrine, Desoxyn, Dexedrine, Methedrine or
  Ritalin)
• 12.  "Downers," "sleeping pills," barbiturates
  or other sedatives (such as Dalmane, Donnatal,
  Doriden, Flurazepam, Halcion, methaqualone
  Placidyl, "quaalude," Secobarbital, Seconal,
  Rohypnol or Tuinal)
• 99. Some other drug (Please describe)(such as
  amyl nitrite, cough syrup, nitrous oxide, Nyquil,
  "poppers" or Robitussin)

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• The answers are..

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Project Implementation Issues in Indian
CountryCandice Stewart-Sabin

• Instrumentation issues (GAIN and cultural
  sensitivity)
  
• Data protection
• Conducting follow-ups